Individual provider Active NPI

Dana Lyn John-Goodrich, MPH, RD

  • Registered Dietitian
  • Fernandina Beach, FL
National Provider Identifier
1730075375
Registry record updated Jun 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND14376 Issued in FL
Practice address
96149 Hanging Moss Dr
Fernandina Beach, FL 32034-5874
Phone
(516) 236-9252
NPI assigned
Jun 17, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X ND14376 FL Primary

Addresses

Primary practice location

96149 Hanging Moss Dr
Fernandina Beach, FL 32034-5874

Mailing address

96149 Hanging Moss Dr
Fernandina Beach, FL 32034-5874
Phone (516) 236-9252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ND14376FLMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750118400000",
    "number": "1730075375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96149 HANGING MOSS DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320345874",
            "telephone_number": "516-236-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96149 HANGING MOSS DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320345874",
            "telephone_number": "516-236-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN-GOODRICH",
        "first_name": "DANA",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "MPH, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-17",
        "last_updated": "2025-06-17",
        "certification_date": "2025-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "FL",
            "license": "ND14376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fernandina Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.